What Is an Intraperitoneal Injection?

Endoperitoneal organs: Endoperitoneal organs are covered with peritoneum on all sides of the abdominal organs. Organs belonging to this category include the stomach, upper duodenum, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, spleen, ovary, and fallopian tube. Internal peritoneal organs are often ruptured by the peritoneum due to inflammation or trauma. The peritoneum plays an important role in maintaining and fixing these organs ^[1] .

Endoperitoneal organs: Endoperitoneal organs are covered with peritoneum on all sides of the abdominal organs. Organs belonging to this category include the stomach, upper duodenum, jejunum, ileum, cecum, appendix, transverse colon, sigmoid colon, spleen, ovary, and fallopian tube. Internal peritoneal organs are often ruptured by the peritoneum due to inflammation or trauma. The peritoneum plays an important role in maintaining and fixing these organs ^[1] .

Chinese name

Intraperitoneal organ

Foreign name

intraperitoneal organ

Department

Anatomy

Overview of intraperitoneal organs

1. Stomach: The enlarged part of the human and animal digestive tract is the organ that stores and digests food.

2. Upper duodenum: the first section of duodenum, also called the upper horizontal part of duodenum. The upper part of the duodenum is the shortest, starting from the pylorus of the stomach, going up to the right to the neck of the gallbladder, and then turning downward to form the duodenal upper curve, which migrates in the descending part. The upper part near the pylorus is spherical when viewed on X-ray barium meal, so it is called the duodenal bulb. Duodenal ulcers are common in this part.

3. Jejunum: The upper end of the jejunum is from the duodenum jejunum, and the lower ileum is located in the upper left part of the abdominal cavity, occupying 2/5 of the proximal end of the full length of the jejunum. In appearance, the diameter of the jejunum is thicker, the wall is thicker, there are more blood vessels, and the color is red, which is the main digestion and absorption site of nutrients.

4. Ileum: refers to the upper end from the jejunum, the end is connected to the cecum, and is located in the lower right part of the abdominal cavity, occupying 3/5 of the full length of the jejunum. In appearance, the ileum has a thinner diameter, thinner walls, fewer blood vessels, and lighter colors. Collective lymphoid follicles are present in the lower mucosa of the ileum. Lesions of intestinal injury occur in the collective lymphoid follicles, which can be accompanied by bowel perforation or intestinal bleeding.

Peritoneal organ anatomy

1. Stomach: The most enlarged part of the gastrointestinal tract, most of which are in the left quarter ribs. Upper esophagus and lower duodenum. The stomach has anterior and posterior walls, and upper and lower margins. The upper edge is short and concave, and it is concave to the right back and upward, which is called a small curvature of the stomach. The small curvature of the stomach near the pylorus has a concave notch called a corner notch. The lower edge is long and convex. The stomach has two openings. The entrance connecting the stomach to the esophagus is called the sacral portal and the exit connecting to the duodenal bulb is the pylorus. The stomach is divided into three parts: the gastric fundus, the gastric body, and the pylorus. The bottom of the stomach is above the level of the cardia. The body of the stomach is between the level of the cardia and the plane of the angular notch. The part between the angle notch plane and the pylorus is the pylorus, which can be divided into a slightly enlarged pyloric sinus and a tubular pylorus near the pylorus. The portion of the pylorus near the small curve is a common site for gastric ulcers. The main physiological function of the stomach is to store food, secrete gastric juice and stir, empty the movement, to prepare and transport food for digestion and absorption in the small intestine.

2. Jejunum: It starts from the duodenal jejunum and accounts for about 2/5 of the total length of the jejunum and jejunum. It mainly occupies the upper left part of the abdominal cavity. The diameter of the tube is large and the wall is thick. The distribution is rich, so the colors are slightly different. The bowel loops are mostly arranged horizontally. The mucosal ring-shaped ridges are tall and dense, and the villi are well developed and dense. There are many scattered lymph solitary nodes in the mucous membrane, and occasionally lymphatic nodules can be found. Each lymph node is composed of about 10 to 70 lymph nodes. It is most noticeable in childhood and gradually declines in old age. Lymph nodes sometimes break through the mucosal myometrium and expand into the submucosa.

3, ileum: curl, forming a small bowel, its diameter is thin, the wall is thin, the color is slightly lighter than the jejunum. Most of the ileum crest is located in the right groin area, and only a small part is located in the pelvic cavity. Generally, the ileum loops are arranged vertically, but the arrangement of small bowel loops varies from person to person, and often changes with different physiological conditions. The end of the ileum, from left to right, across the front of the psoas muscle to the right popliteal fossa, is connected to the inside of the junction of the cecum and ascending colon, and leads to the large intestine through the ileocecal opening.

There are many lymph nodes in the ileal mucosa, which is one of the main characteristics of the ileum. Lymph nodes are mostly distributed in the mucosa of the independent edge of the intestinal wall, and are oval or oblong in shape. The long diameter is consistent with the long axis of the intestine. 30, significantly more than the jejunum. There are also lymph nodes in the ileal mucosa, the number of which is uncertain.

Diseases related to endometrial organs

1. Gastric ulcers: Small ulcers of the stomach and duodenum are difficult to observe during a barium meal examination and cannot be seen on plain films. Large ulcers can be observed when the X-rays are projected from the side if they extend beyond the contours of the edge of the stomach wall. Large benign ulcers are usually arranged in the small curvature of the stomach. When the large crater of the ulcer is filled with gas, it appears as a round, translucent protrusion adjacent to the stomach cavity.

In most cases, the part that is connected to the stomach is usually clear, but some ulcerative neck mucosal edema produces a gray shadow, which makes people mistakenly think that the ulcer's sac is separated from the rest of the gastric vesicle. At the same time, the accumulation of cellular debris on the bottom of the ulcer can also cause the deformation of the ulcer shadow.

Inflated ulcers should not be mistaken for gastric diverticula. Diverticula are usually located at the bottom of the stomach, far from the small curvature of the stomach where large ulcers occur. In addition, the gastric diverticulum can be inferred to be located on the posterior wall and cannot be observed on the plain film because the diverticulum is almost always filled with fluid when the patient is in the supine position. An inflated small intestine overlapping the small curvature of the stomach is usually easy to identify from the crater of the ulcer because of its characteristic petal-like clustering signs. However, the uniform translucent shadow formed by the diverticulum of the fourth segment of the duodenum or the proximal jejunum is very similar to that of a large gastric ulcer.

2. Jejunum and ileum: inflammation of the jejunum and ileum mucosa. Can be caused by microbial or intestinal parasite infections. With abdominal pain and diarrhea as the main symptoms, fever and malnutrition sometimes occur ^[2] .

3. Chronic ulcerative jejunal ileitis: This disease refers to primary diffuse ulcerative non-granulomatous jejunum-ileum, which is characterized by multiple ulcers in the jejunum and ileum with diffuse or flat mucosa, clinical There are severe malabsorption syndromes, but a gluten-free diet is ineffective. This is a rare and serious disease that often dies within 2 years of onset.

Pathological characteristics of ulcers are multiple, mostly in the jejunum, some in the ileum, and a few can also be seen in the duodenum. The depth of the ulcer varies, but most penetrate the muscularis mucosa and perforations are common. Inflammation is limited to the base of the ulcer. See lymphocytes, plasma cells, histiocytes and neutrophils, no granulomas and focal inflammation. Mucosa between ulcers is flat. The course of the disease can evolve into lymphoma, often histiocytic lymphoma, or mixed lympho-histiocytic lymphoma. The most prominent of this disease is chronic diarrhea with malabsorption syndrome and / or protein-losing bowel disease. Abdominal pain, fever and weight loss. Intestinal obstruction or perforation can occur, develop rapidly, and die from complications in 1 to 2 years. Surviving elders can develop lymphoma. Laboratory tests for hypoalbuminemia, hypocalcemia, celiac disease, intestinal protein loss, and hypoglobulinemia. Anemia is common. There is no good treatment; surgery is appropriate once complications occur. Lymphoma can be tested for chemotherapy ^[3] .